What could cause persistent fevers of 3+ months in a young adult? All regular blood work is “perfectly normal” including rheumatoid testing, yet temps range from fairly normal upon rising to 100.5-102.8 in the evenings, with maybe a few scattered days of no apparent rise.
Thanks.
malaria, cancer, TB, medications, familial mediterranean fever, UTI, thyroid issues
I’m not a doctor though. Have they seen an internal medicine specialist?
What is the doctor saying? Honestly, you’ll drive yourself batty if we all give you dozens of “what if’s”.
An occult infection of some sort? Other autoimmune issues? (Is ANA negative?)
Has a Lyme test been done? It should be a Western Blot, not the usual screening Elisa, which has a lot of false negatives. There are controversies on interpretation. Some docs will say it is positive if there is even one Lyme-specific band. Make sure you get the results back yourself and consult someone who knows Lyme and co-infections.
Otherwise, if current doctors cannot solve this, you might want to see a functional medicine doc. They are often complementary to primary care but can be helpful in mysteries like this.
@abasket - at first, three+ months ago, the dr. said Covid and take the usual precautions, blah, blah, blah. Neither my H or I have become ill and my S is still having fevers., slight cough (that may be allergy) and fatigue. @bouders mentioned FMF, and I’m going to ask about that bc since childhood, my S had has a history of inflammation, most recently chest pain that was dx as inflammation of the ribcage.
So, thank you! Now, back to my bagel baking!
eta: thanks @compmom I will look at those things. As a child, he had an ANA of 1:320 (if my memory serves me correctly) with a speckled pattern. He was young, 5 ish, and I don’t think the dr. paid too much attention back then.
I’m going to check what the most recent ANA was (if it was done). Thank you for your thoughts. I am becoming more concerned and I need to get my S onboard without worrying him
My BIL had something similar, except lower temps more in the 99-100 range. After months of testing for all sorts of things including lyme disease, etc it turned out to be low vitamin D. He’s on supplements now and back to normal.
That said, I agree with another poster that you can drive yourself nuts asking people for opinions and should focus on what the doctors are saying; and of course see different docs - I think my BIL went through several before finally getting a diagnosis.
Not to worry you but have him checked out for lupus or the like. Will give you the low grade fevers, fatigue, chest pains and speckled Ana like Rheumatoid Arthitis does. https://www.emedicinehealth.com/lupus_systemic_lupus_erythematosus_health/article_em.htm
That ANA is abnormal but not horribly. I have lupus and have had an ANA of 1:5280. Normal is 1:40. It goes up to 1:80, 1:160, then 1:320, 1:640 and so on. Lyme can also elevate ANA but if he had an elevated ANA when he was younger, that explanation is unlikely in terms of the ANA anyway.
One of my kids had 1:320 and docs don’t pay attention until there are symptoms that cause you to pay attention. Now your son has a reason to pursue.
I have been told that ANA level doesn’t always correlate with severity of illness, but in my experience it has been high when very ill. That said, once it is positive, docs often don’t test it again.
He probably has an autoimmune problem of some sort. It can take awhile to figure out what, believe me.
You would also want to look at sedimentation rate and CRP, markers of inflammation. Anti-DNA is specific for lupus, ANA is not.
This is not a case where you should avoid “driving yourself crazy.” Some of us parents with kids with mysterious illness go through a lot of distress finding an answer. But you have to to it.
Something IS wrong and you can’t just ignore it. If the doctor you have is not responding, you will need to see other docs. Has your son seen a good rheumatologist?
Feel free to PM me.
ps I also get costochondritis, the chest inflammation you mentioned
@compmom Thanks. I will PM you a little later. My sister has lupus, so I suppose it is a possibility, and yes, costochondritis was the name of the inflammation. I forgot the name until you said it.